Test Directory

Test Code
1492
Test Name
Capillary Malformation Malformation Arteriovenous
CPT Codes
81479
Expected Turnaround Time
Typically 2 to 4 weeks from receipt of a sample in the laboratory. All cases involving ongoing pregnancies will be expedited.
Clinical Utility
Genetic analysis to provide a molecular diagnosis of this disorder. Recommended for individuals with a personal and/or family history of this disorder to ensure appropriate treatment and establish recurrence risk for family members.
Specimen and Container Info

Non-Prenatal Specimens

Preferred/Alternate

Specimen Type

Containers

Volume

Preferred Specimen Type

Whole Blood

Lavender Top (EDTA)

3 mL

Alternate Specimen Type

Genomic DNA

1.5 mL Tube

3 µg (at a concentration of at least 30 ng/µl), preferably in TE solution.

Alternate Specimen Type

Fibroblasts

T-25 Flasks

2 confluent T-25 flasks, filled to capacity

Alternate Specimen Type

Saliva (Whole blood is recommended for CNV)

DNA Self-Collection Kit or Oragene Saliva Collection Kit for Young Children

Follow kit instructions (www.dnagenotek.com)

Prenatal Specimens

Either specimen type below is acceptable.

Specimen Type

Containers

Volume

Cultured cells

T-25 Flasks

2 confluent T-25 flasks derived from amnio or CVS samples.

Genomic DNA

1.5 mL Tube

3 µg (at a concentration of at least 30 ng/µl), preferably in TE solution.

NOTE: For specimens from outside of North America, the preferred specimen type is Genomic DNA. HNL Genomics does not recommend shipping whole blood or cultured cells from any location other than the United States, Canada, or Mexico.

Transport Instructions
  • Transport at room temperature within 24 hours.
  • If the specimen cannot be transported to the lab within 24 hours, refrigerate for up to 72 hours.
  • Do not freeze or expose to extreme temperatures, refrigerate for up to 72 hours if cannot be transported to lab within 24 hours. 
Stability Requirements

Room Temperature

24 hours

Refrigerated

72 hours

Causes for Rejection
  • Improperly labeled specimen (minimum of two patient identifiers)
  • Inappropriate specimen type
  • Incomplete or incorrect test request form
  • Insufficient volume
  • Specimen has leaked in transit
  • Specimen without a test order
Methodology
Next Generation Sequencing and Copy Number Variation Analysis
Performing Location
Genomics - Snowdrift
Alternate Names
CMAVM
Description

RASA1 related disorders - Capillary malformation-arteriovenous malformation (CMAVM; MIM 608354) and some cases of Parkes Weber syndrome (PKWS; MIM 608355) are caused by mutations in the RASA1 gene. Capillary malformation-arteriovenous malformation (CMAVM) is an autosomal dominant disorder characterized by multiple capillary malformations or port-wine stains, in addition to fast-flow vascular lesions.  The capillary malformations are small flat cutaneous lesions that vary in number from a single malformation to multiple randomly distributed malformations. The associated fast-flow vascular lesions include arteriovenous malformations (AVM) and arteriovenous fistulas (AVF) which have been described in the skin, bone, internal organs and brain. The fast-flow lesions described in patients with CMAVM can be life-threatening and cause epilepsy, seizures, hydrocephalus, heart failure and death. There is evidence of phenotypic variation in CMAVM families as fast-flow lesions have been described in only one third of patients and some families have no individuals with fast-flow lesions. Mutations in the RASA1 gene have also been associated with Parkes Weber syndrome (PKWS), an autosomal dominant disorder previously considered to be a sporadic overgrowth syndrome with unknown etiology.  PKWS is characterized by a large vascular stain with multiple underlying micro-arteriovenous fistulas and soft tissue and skeletal hypertrophy of the affected limb.  PKWS is clinically and etiologically heterogeneous as some individuals with PKWS who lack cutaneous capillary malformations do not have an identifiable RASA1 mutation.

RASA1 encodes RAS p21 protein activator 1 (GAP), a member of the GAP1 family of GTPase-activating proteins. It is an inhibitor of RAS p21, which controls cellular growth, proliferation and differentiation.  The GAP protein has also been implicated in the remodeling of the actin cytoskeleton and integrin-mediated cellular adhesion.

Testing Schedule
Monday-Friday
Genes
RASA1
MIM
608354
Disease Group
Cardiovascular Disorders, Dysmorphology, Hair and Nail disorders, Skin